Orthognathic Surgery Associated with Condylectomy for Treatment of Mandibular Osteochondroma: Case Report

ABSTRACT: Osteochondroma is a common benign bone tumor and although its involvement in facial bones is rare (0.6 %), it shows a strong predilection for developing in the mandibular condyle, causing occlusal changes and facial asymmetry. The aim of this study was to report a clinical case and the treatment of a 43-year-old male patient, who was diagnosed with condylar osteochondroma. Clinically, the patient presented an increase in volume in the right condylar region, deviation of the mandible to the left side and malocclusion. His main complaint was his facial asymmetry. Imaging exams showed changes in the size and morphology of the right condyle, and signs of hyper-capture on scintigraphy. The hypothesis of condylar hyperplasia and osteochondroma was raised. A virtual planning and execution of an orthognathic surgery of the jaws was performed to correct the occlusion and facial asymmetry, besides a low condylectomy to remove the lesion. Procedures such as high, low, proportional condylectomy, orthognathic surgery and TMJ reconstructive surgery are alternatives for the treatment of these pathologies. In our case, the orthognathic surgery combined with a condylectomy proved to be promising, to correct the occlusion and the facial asymmetry of the patient.

RESUMEN: El osteocondroma es un tumor óseo benigno común y aunque su afectación en los huesos faciales es rara (0,6 %), muestra una fuerte predilección por desarrollarse en el cóndilo mandibular, causando cambios oclusales y asimetría facial. El objetivo de este trabajo fue informar de un caso clínico y el tratamiento de un paciente de sexo masculino de 43 años, que fue diagnosticado con osteocondroma cóndilar. Clínicamente, el paciente presentaba un aumento en el volumen en la región condilar derecha, desviación de la mandíbula hacia el lado izquierdo y maloclusión. Su principal molestia era su asimetría facial. Los exámenes por imágenes mostraron cambios en el tamaño y la morfología del cóndilo derecho, y signos de hiper-captura en la centellografía. Se planteó la hipótesis de hiperplasia condilar y osteocondroma. Se realizó una planificación virtual y ejecución de una cirugía ortognática de la mandíbula para corregir la oclusión y la asimetría facial, además de una baja condilectomía para extirpar la lesión. Procedimientos como la condilectomía alta, baja y proporcional, la cirugía ortognática y la cirugía reconstructiva de la ATM son alternativas para el tratamiento de estas patologías. En nuestro caso, la combinación de la cirugía ortognática y una condiloectomía resultó ser prometedora, para corregir la oclusión y la asimetría facial del paciente.

Morphometric Study Of Occipital Condyles In North Indian Skulls

Introduction: Occipital condyles are two bony elevations present on either side of foramen magnum in the baseof the skull which articulates with the superior articular facet of the atlas vertebra, connecting the skull with thevertebral column.Objectives: Morphometric analysis of occipital condyles is important for the neuro-surgeons operating for thepathology like degenerative changes of the condyles, neoplasms, and trauma. So the aim of the study wasmorphometric analysis of the occipital condyles and observe any morphological variations of it.Materials and Methods: The study was conducted on 60 occipital condyles of 30 dry adult skulls. Length,breadth, height, intercondylar distance were measured. Relations of hypoglossal canal with the condyles werenoted.Results: The mean length, width and height of occipital condyle were found to be 1.99± 0.33 (right), 2.23 ± 0.33(left), 1.31± 0.28(right) 1.37±0.27 (left), 0.62± 0.17(right) and 0.62± 0.14cm (left), respectively. The mean anteriorintercondylar distance and posterior intercondylar distance were measured as 1.95± 0.34and 3.66± 0.28 cm,respectively. Variations of shape of occipital condyle were kidney like (30%), S-like (23.33%), triangular (16.67%)oval (10.0%), eight like (16.7%) and bipartite condyles (3.33%) respectively. The hypoglossal canal was presentrelated to anterior 1/3 of the occipital condyles in 73.33% case.Conclusions: The shape and morphometric values of occipital condyles are variable. So the knowledge of thesevariations may guide neurosurgeons in transcondylar approach in the management of neoplasms and otherpathology related to this region.

Manejo Quirúrgico de la Hiperplasia Condilar Tipo 2: Reporte de un Caso / Surgical Management of Mandibular Condylar Hyperplasia Type 2: Case Report

RESUMEN: La hiperplasia condilar (HC) es un término genérico de una condición patológica que se utiliza para describir situaciones que causan el crecimiento excesivo y sobredesarrollo del cóndilo mandibular, repercutiendo así también en la mandíbula, es la responsable de alrededor del 50 % de las asimetrías faciales y se presenta con mayor frecuencia entre los 11 y 30 años de edad. Se presenta un caso clínico de una paciente femenina de 21 años de edad que presentaba hiperplasia condilar unilateral izquierda con compensación alveolodentaria. Se realizó condilectomía alta con abordaje endoaural para retirar 5 mm de la parte superior del cóndilo y osteotomía mandibular mediante abordaje intraoral circunvestibular, con disección y preservación del nervio dentario inferior, retirando 8 mm del aspecto inferior de la mandíbula de acuerdo a los requerimientos estéticos. El brindar un tratamiento adecuado a la hiperplasia condilar enfocado a corregir las secuelas tanto funcionales como estéticas es de gran beneficio al paciente ya que le permite mejorar su calidad de vida, el correcto diagnóstico es vital para poder planear un tratamiento exitoso.

ABSTRACT: Condylar hyperplasia (CH) is a generic term for a pathological situation that is used to describe conditions that cause excessive growth and overdevelopment of the mandibular condyle and also impacting on the jaw, this bone formation is responsible about of 50 % of all deformities facial and it occurs most frequently between 11-30 years old. This case report is about a 21-years old female who showed unilateral condylar hyperplasia of left side with alveolodentary compensatory. Was carried out high condilectomy through an endoaural approach removing 5 mm of the upper condyle and the mandibular osteotomy was performed through intraoral approach with dissection and preservation of the inferior alveolar nerve, removing 8 mm of the inferior aspect of the mandible according to the aesthetic requirements. An appropriate treatment for the condylar hyperplasia focused on correcting the side effects such as functional or aesthetic it's of great benefit for the patient because it allows improve their quality of life. A correct diagnosis is very important to planning a successful treatment.

Condilectomia alta associada à discopexia, com âncoras, no tratamento da hiperplasia condilar: relato de caso / Highcondilectomy associated to discopexy with anchor for conylar hyperplasia treatment: a case report

Introdução: A hiperplasia condilar (HC) é uma patologia rara caracterizada por crescimento não neoplásico que afeta a morfologia do côndilo mandibular com deformação progressiva. Dentre os sinais mais comuns destacam-se a assimetria facial e mandibular, além de possíveis alterações oclusais como mordida aberta ipsilateral e transversal contralateral. A combinação de exames clínicos com a análise de modelos de gesso, fotografias, radiografias panorâmicas, cintilografias e cefalogramas são essenciais para definição do correto diagnóstico. Objetivo: O objetivo do estudo foi demonstrar a eficácia terapêutica da condilectomia alta no tratamento da hiperplasia condilar. Relato de caso: paciente jovem, 24 anos de idade, apresentando assimetria facial, déficit e incompetência funcional mastigatória, mordida aberta posterior ipsilateral e mordida cruzada posterior contralateral. A proposta terapêutica escolhida foi o tratamento cirúrgico com condilectomia alta e discopexia com âncora para estabilização do disco articular, através de acesso endaural para o côndilo afetado. Conclusão: A condilectomia alta preveniu a deformidade facial progressiva, minimizando as sequelas funcionais e estéticas, favorecendo o tratamento das deformidades faciais.

Introduction: Condylar hyperplasia is a rare disorder characterized by a non-neoplastic pathological growth that affects the morphology of the mandibular with progressive deformation. Clinical examination, plaster model's analysis, clinical photographs, panoramic radiography, scintigraphyandcephalograms in combination are essential to make a correct diagnosis. Among the most common signs and symptoms of the condition are facial and mandibular asymmetry, and occlusal changes such as contralateral ipsilateral and cross open bite. Objective: The aim of the study was to describe the efficacy of high condilectomy in the treatment of condylar hyperplasia. Relato de caso: Young patient, 24 years-old, presenting facial asymmetry, functional masticatory deficit and functional incompetence, ipsilateral posterior open bite and contralateral posterior crossbite. The therapeutic proposal chosen was the surgical treatment with high condilectomy and discopexy with anchor for stabilization of the articular disc through endaural access to the affected condyle. Conclusion: The high condylectomy, prevents progressive facial deformity minimizing the functional and aesthetic sequelae, which favors the treatment of facial deformities.

Surgical Treatment of Condylar Hyperplasia Associated with Dentofacial Deformity: Low Condylectomy, Articular Disc Repositioning, and Orthognathic Surgery / Tratamiento Quirúrgico de Hiperplasia Condilar Asociado a la Deformidad Dentofacial: Condilectomía Baja, Reposicionamiento del Disco Articular y Cirugía Ortognática

Due to the complexity of the treatment of condylar hyperplasia associated with dentofacial deformities and its complications, if left untreated, the surgeon should be alert to these factors at the time of surgical planning to tailor the optimal therapy for an individual patient. This case report describes a patient with right condylar hyperplasia associated with dentofacial deformity who was treated surgically with low condylectomy, articular disc repositioning and anchoring, and orthognathic surgery, concomitantly, with stable results, satisfactory occlusion and facial harmony.

Debido a la complejidad del tratamiento de la hiperplasia condilar asociada con deformidades dentofaciales y sus complicaciones, si no se trata, el cirujano debe estar alerta ante estos factores en el momento de la planificación quirúrgica para adaptar la terapia óptima para cada paciente. Este caso describe un paciente con hiperplasia condilar derecha asociada con la deformidad dentofacial que fue tratado quirúrgicamente con condilectomía baja, reposicionamiento y anclaje del disco articular, y la cirugía ortognática, concomitantemente, con resultados estables, oclusión satisfactoria y armonía facial.

Condylar hyperplasia, diagnosis and clinical management: a clinical case report / Hiperplasia condilar, diagnóstico y manejo clínico: a propósito de un caso clínico

ABSTRACT Condylar hyperplasia is a disorder characterized by excessive and progressive growth affecting the condyle, neck, body, and mandibular ramus. Under this condition, mandibular growth occurs in all three planes of space, but more predominantly in one of them. Its etiology is controversial in its own. Some of its suggested causes include: trauma, hypervascularity, infections, and hereditary/intrauterine factors. Treatment protocols are varied, but one of the best treatment choices is high condylectomy. Following is the case of a 16-year-old female patient with this anomaly. The physical exam showed free facial asymmetry with mandibular deviation. Treatment consisted of TMJ surgery and high condylectomy plus a second orthodontic stage. The clinical outcomes at two-year follow-up suggest that a second intervention won′t be necessary. Patient was very satisfied with the results.

RESUMEN La hiperplasia condilar es una alteración caracterizada por crecimiento excesivo y progresivo, que afecta el cóndilo, el cuello, el cuerpo y la rama mandibular. Bajo esta condición, el crecimiento mandibular ocurre en los tres planos del espacio, pero con predominio por alguno de ellos. La etiología de la misma es motivo de controversia. Se sugieren como sus causas: traumatismos, hipervascularidad, infecciones y factores hereditarios e intrauterinos. Los protocolos de tratamiento son variados, pero una de las mejores opciones de tratamiento es la condilectomía alta. Se presenta el caso de una paciente de género femenino de 16 años de edad, portadora de esta anomalía. Al examen físico, se observa una franca asimetría facial con desviación mandibular. El tratamiento consistió en una cirugía de articulación temporomandibular con condilectomía alta y luego una segunda etapa ortodóntica. Los resultados clínicos a dos años de seguimiento sugieren que no será necesario hacer una segunda intervención. La paciente mostró alto grado de satisfacción con los resultados obtenidos.

Mandibular condyle repair after partial condylectomy in patients with active condylar hyperplasia / Reparación de cóndilos mandibulares después de condilectomía parcial por hiperplasia condilar activa

The different aspects of unilateral condylar hyperplasia have been studied and continue to be controversial; nevertheless, treatment based on condylectomy has been established as part of the working protocol. The aim of this investigation was to identify the bone repair observed in surgically treated condyles after 1 year using cone beam computed tomography (CBCT). Nine subjects were included in this study (6 female and 3 male) with an average age of 18.5 years. They had been diagnosed with active unilateral condylar hyperplasia using SPECT, clinical follow-up of progressive facial asymmetry and CBCT. Patients underwent exclusive condylectomy surgery with a piezoelectric system without disc replacement, orthognatic surgery or any other type of adjunct surgical procedure. Later, they were treated orthodontically for dental compensation or as preparation for orthognatic surgery. A CBCT was performed in the first postoperative month and after 1 year from the surgery to analyze variables. The CBCT at 1 month showed a clear and distinct slice of the condyle without defects or irregularities; the distance from the condylar remnant to the articular fossa reached 8.5 mm in the most extreme case. After 1 year, condylar bone remodeling was observed, with areas of lateral and superior curvature and characteristics of normal condyles, with cortical bone present and a maximum distance of 4.5 mm from the condylar fossa. In conclusion, condylar repair and remodeling can be obtained in these types of surgeries and the morphology of resected condyles after 1 year is quite close to normal macroscopic anatomy.

La hiperplasia condilar unilateral ha sido estudiada en diferentes aspectos y continua siendo controversial; aun así, el tratamiento en base a condilectomía se establece como parte del protocolo de trabajo. El objetivo de esta investigación es reconocer la reparación ósea observada en cóndilos operados después de 1 año mediante tomografía computadorizada cone beam (TCCB). Nueve sujetos fueron incluidos en este estudio (6 sexo femenino y 3 sexo masculino) con una edad promedio de 18,5 años; en ellos se realizó el diagnóstico de hiperplasia condilar unilateral activa mediante estudio de SPECT, seguimiento clínico de la asimetría facial progresiva y TCCB. Se realizó la cirugía de condilectomía exclusiva con sistema piezoeléctrico sin reposición de disco, cirugía ortognática u otro tipo de procedimiento quirúrgico adjunto; posteriormente, los pacientes fueron tratados ortodoncicamente para compensación dentaria o para preparación previa a cirugía ortognática. Se realizó TCCB dentro del primer mes postquirúrgico y después de 1 año de realizada la cirugía para análisis de variables. Se observó en la TCCB de 1 mes un corte nítido y neto del cóndilo, sin defectos o irregularidades; la distancia desde el remanente condilar hasta la fosa articular llegó hasta 8,5 mm en el caso máximo. Después de 1 año, se observo remodelación ósea condilar, con áreas de curvatura lateral y superior características de cóndilos normales, con presencia de hueso cortical y con una distancia máxima de 4,5 mm desde la fosa condilar. Se puede concluir que la reparación y remodelación condilar es viable de obtenerse en este tipo de cirugías y que la morfología de cóndilos resecados después de 1 año es bastante próxima de la anatomía macroscópica normal.

Hiperplasia de cóndilo mandibular: reporte de doce casos / Hyperplasia of the mandibular condyle: considerations in a series of 12 patients

Introducción: La hiperplasia condilar (HC) se define como un crecimiento patológico no neoplásico que afecta tanto al tamaño como a la morfología del cóndilo mandibular. Objetivo: Evaluar la eficacia y riesgos del tratamiento quirúrgico de la HC. Material y método: Estudio descriptivo, serie de casos. Se incluyó a todos los pacientes con diagnóstico de HC tratados en el Hospital Clínico de la Pontificia Universidad Católica de Chile entre enero de 2010 y febrero de 2014. Resultados: Doce pacientes fueron operados en nuestra institución por HC. El promedio de edad fue 19,3 ± 3,4 años. La forma de presentación más frecuente fue presencia de asimetría facial. Todos los pacientes fueron estudiados con SPECT que evidenció diferencia de captación mayor a 50% ± 3,1% entre ambos cóndilos. Todos los pacientes fueron tratados con condilectomía mandibular alta del lado afectado y en 3 casos, se realizó además cirugía ortognática en el mismo tiempo para corrección de maloclusión dental. La mediana de seguimiento fue de meses 16 (5 a 54 meses). En todos los pacientes se evidenció una mejora en la oclusión dental y simetría facial, con desaparición de la disfunción articular previa. Conclusiones: La HC es una entidad de poca frecuencia. La cirugía es eficaz y segura para el tratamiento de la HC.

Introduction: Condylar hiperplasia is defined as a pathological non neoplastic growth which compromises both size and shape of the mandibular condyle and is characterized by progressive facial asymmetry. Aim: To evaluate the efficacy and risks of surgical treatment of HC. Material and method: Descriptive study, cohort of cases. All patients between 2010 and February 2014 with diagnosis of condylar hyperplasia at Hospital Clínico P. Universidad Católica de Chile were included. Results: Twelve patients were operated at our institution because of condylar hyperplasia. Age average was 19.3 ± 3.4 years. The most frequent presentation was facial asymmetry. All patients were studied with single photon emission computed tomography (SPECT) with differential intake more than 50 ± 3.1% between both condyles. All patients were treated with mandibular condylectomy of the affected site and in 3 cases orthognatic surgery was performed at the same time of the condylectomy to correct dental malocclusion. Average follow up was 16 months (5 to 54 months). All patients recovered facial symmetry and occlusion with absence of the previous joint dysfunction. Conclusions: Condylar hyperplasia is an unfrequent condition and surgery is efficient and safe for the treatment of the deformity.

Bimaxillary orthognathic surgery and condylectomy for mandibular condyle osteochondroma: a case report / 대한악안면성형재건외과학회지

Osteochondroma is rarely reported in the maxillofacial region; however, it is prevalent in the mandibular condyle. This slowly growing tumor may lead to malocclusion and facial asymmetry. A 39-year-old woman complained of gradual development of anterior and posterior unilateral crossbite, which resulted in facial asymmetry. A radiological study disclosed a large tumor mass on the top of the left mandibular condyle. This bony tumor was surgically removed through condylectomy and the remaining condyle head was secured. Subsequently, bimaxillary orthognathic surgery was performed to correct facial asymmetry and malocclusion. Pathological diagnosis was osteochondroma; immunohistochemistry showed that the tumor exhibited a conspicuous expression of BMP-4 and BMP-2 but rarely expression of PCNA. There was no recurrence at least for 1 year after the operation. Patient's functional and esthetic rehabilitation was uneventful.

Assessment of functional improvement with temporalis myofascial flap after condylectomy in elderly patients with anterior disc displacement without reduction and an erosive condylar surface / 대한악안면성형재건외과학회지

BACKGROUND: The purpose of this study was to investigate the functional effects of temporalis myofascial flap after condylectomy, with or without disc removal, in elderly patients with anterior disc displacement (ADD) without reduction and an erosive condylar surface of the temporomandibular joint (TMJ). METHODS: A total of 15 joints from 11 elderly patients (71-78 years old) were included. The patients had pain, mandibular dysfunction symptoms, and unilateral or bilateral ADD as well as an erosive condylar surface of the TMJ. All patients underwent temporalis myofascial flap reconstruction after condylectomy, with or without disc removal. If the maximal mouth opening (MMO) remained <35 mm after condylectomy, coronoidotomy was also performed. Self-assessed pain and mandibular function, including MMO and protrusive and lateral movements, were evaluated. RESULTS: No patient experienced serious complications. Most measurements improved significantly after surgery compared to preoperatively. Most patients achieved nearly-normal mouth opening at 4 weeks after surgery. Although most patients felt discomfort during active postoperative physiotherapy, no patient reported serious pain during the follow-up period. CONCLUSION: Although nonsurgical therapy is often the first treatment choice for ADD without reduction of the TMJ, surgical intervention involving condylectomy and temporalis myofascial flap reconstruction may be a reasonable first option for elderly patients with an erosive condylar surface of the TMJ.

Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.

Chronic dislocation of temporomandibular joint persisting for 6 months: a case report

Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

Hiperplasia condilar: considerações sobre o tratamento e relato de caso / Condylar hyperplasia: treatment considerations and report of a case

A Hiperplasia do Côndilo Mandibular (HCM) corresponde a uma má-formação de desenvolvimento, caracterizada por um crescimento condilar excessivo e autolimitado, resultando em assimetria facial e distúrbios oclusais. A etiologia desta condição ainda não foi totalmente esclarecida, apesar de fatores, como traumatismo prévio, distúrbios hormonais e doenças articulares, terem sido apontados como possíveis causas. Existem diversas classificações para a HCM e, a depender da modalidade de apresentação, poderemos ter diferentes formas de tratamento. Diante de tantos tratamentos possíveis, eleger o modelo mais adequado pode ser um desafio. O objetivo deste trabalho é o de apresentar o caso de um jovem de 14 anos, portador de HCM em atividade, tratado precocemente pela condilectomia alta sem a necessidade de cirurgia ortognática adicional.

Mandibular condylar hyperplasia is a malformation of development of development, characterized by an excessive and self-limitating condylar growth, resulting in occlusal disturbances and facial asymmetry. The etiology of this condition has not yet been fully clarified despite the fact that factors like previous trauma, hormonal disturbances and joint diseases have been indicated as possible causes. There are many classifications of the condition and different forms of treatment are possible depending on the type of presentation. In view of this, choosing the most appropriate form of treatment may represent a challenge. The purpose of this paper is to present the case of a fourteen-year-old boy with an active mandibular condylar hyperplasia treated previously by a high condylectomy without the need for any further ortognatic surgery.

Hemimandibular Elongation: A Case Report With A 7-Year Follow-Up

One of the many growth anomalies that affect the mandibular condyle is hemimandibular elongation without any condylar hyperplasia. Condylar growth patterns can be evaluated by serial clinical comparisons, cephalometric tracings and bone scanning with technetium 99m phosphate. However, no ideal method has been found to assess whether condylar overgrowth is “inactive”. Therapy is guided by the patient's age and condylar growth activity. Treatment modalities have ranged from condylectomy to orthopedic maxillary management. A case is presented where one such patient was treated with condylectomy and a long follow-up of seven years showing stable results after surgery.

Osteochondroma of the temporomandibular joint: a case report

Osteochondroma of the mandibular condyle has been found in the oral and maxillofacial region rarely. This paper describes a case of osteochondroma of the mandibular condyle in a 20-year-old woman, who was referred to our service with facial asymmetry, prognathic deviation of chin, cross-bite to the contralateral side, changes in condylar morphology, limited mouth opening, and malocclusion. Computed tomography (CT) was performed for better evaluation to the pathological conditions on the temporomandibular joint. Based on the clinical examination, patient history, and complementary exams, the hypothesis of osteochondroma was established. Condylectomy was performed using a preauricular approach with total removal of the lesion. After 3 years of postoperative follow up and orthodontic therapy, the patient is symptom-free, and has normal mouth opening with no deviation in the opening pattern.

Osteocondroma de côndilo mandibular é raro na região craniofacial. Este artigo descreve um caso de osteocondroma de côndilo mandibular em uma mulher de 20 anos que foi encaminhada ao nosso serviço apresentando assimetria facial, desvio de mento, mordida cruzada para o lado contralateral, alterações na morfologia condilar, limitação de abertura bucal e maloclusão. Tomografia computadorizada foi realizada para melhor avaliação da condição patológica da ATM. Devido à base no exame clínico, histórico do paciente e exames complementares, foi estabelecida uma hipótese de osteocondroma. Um procedimento de condilectomia utilizando abordagem preauricular com uma total remoção da lesão foi executado. Após três anos de acompanhamento pós-operatório e ortodôntico, o paciente está livre dos sintomas e tem uma abertura normal sem desvio de padrão durante a abertura.

OSTEOCHONDROMA OF THE MANDIBULAR CONDYLE AND ACCOMPANYING FACIAL ASYMMETRY: REPORT OF A CASE

Application and effects of condylectomy in asymmetric patients with condylar hyperplasia / 대한치과교정학회지

Condylar hyperplasia is a pathologic condition showing 3-dimensional skeletal hyperplasia of the mandible. The reason for condylar hyperplasia is not yet known, but the effects of hormone, trauma, infection, genetics, fetal condition, and hypervascularity are known as possible reasons. When we diagnose a patient as having condylar hyperplasia, it is important to decide if it is in progress or not. Treatment for facial asymmetry due to condylar hyperplasia are decided accordingly, including condylectomy, that is removal of growth site of the affected condyle, and conventional orthognathic surgery only or condylectomy with orthognathic surgery after the completion of growth. Therefore, it is important to determine the growth state of condylar hyperplasia in treatment stability. This is verified through bone scan and regular check-ups with 3D CT or PA cephalogram. This case report introduces an improved case of facial asymmetry with condylectomy together with orthognathic surgery.

A Case Report Of Facial Asymmetry From Unilateral Condylar Hyperplasia